Which cataract type is most strongly associated with long-term corticosteroid use?

• A. Nuclear cataract
• B. Posterior subcapsular cataract
• C. Cortical cataract
• D. Congenital cataract

Answer: (B)

Long-term corticosteroid use is most strongly associated with a posterior subcapsular cataract. This type forms just in front of the posterior capsule at the back of the lens, and steroids disrupt the function and differentiation of lens epithelial cells in that region, leading to the accumulation of abnormal proteins and changes that create a localized opacity there. Clinically, PSCs often cause glare and decreased vision that can progress quickly with continued steroid exposure, making them more vision-threatening early on compared with other types.

Nuclear cataracts are age-related changes in the lens nucleus, causing central yellowing and hardening. Cortical cataracts produce spoke-like opacities in the lens cortex and are also related to aging. Congenital cataracts are present at birth due to genetic or developmental factors and are not tied to steroid use. Thus, the pattern most characteristically linked to long-term corticosteroids is the posterior subcapsular cataract.